Breast Cancer
SEAN DAVENPORT
BRIANNA CANTRELL
ASHLEY CLARK
DANA OMARI
EMILY SMITH
OLIVIA WOOLIVER
Breast Cancer
 Breast cancer refers to a malignant tumor that has

developed from cells in the breast
 Cells of the lobu...
What are the symptoms?
 Swelling of all or part of the breast

 Skin irritation or dimpling
 Breast pain
 Nipple pain ...
Overview of Vitamin D
 Role in serum calcium homeostasis – acts to

increase or decrease serum calcium levels
 Also aids...
Overview of Calcium
 Calcium plays a regulatory role in cell proliferation,

differentiation, and apoptosis
 Experimenta...
Study 1: Intakes of Calcium and Vitamin
D and Breast Cancer Risk in Women
 Background
 Increasing Calcium and Vitamin D ...
Dietary Assessment
 Food frequency questionnaire
 Average

use of food and beverages past 12

months
 Calcium and Vitam...
Ascertainment of Breast Cancer Cases
 Follow up questionnaires on whether breast cancer

was diagnosed
 Every 6 months f...
Influences
 Examination of dietary factors
 Vitamin

D
 Phosphorus
 Fat
 Lactose
Results
 Relation to function:
 Premenopausal

women
Higher intakes of total Calcium & Vitamin D
were associated with l...
Discussion
 Calcium, Vitamin D, and IGFs:
 Suggestion

that Calcium & Vitamin D have
anti-cancer effects on breast cance...
Discussion
Strengths

Weaknesses

 Large sample size

 Possible confound

 Prospective design

 Nutrient intake only

...
Study 2: Long-term dietary calcium intake
and breast cancer risk in a prospective cohort of women

 To examine the potent...
Subjects and Methods
 Swedish Mammography Cohort
 Population-based cohort of 61,433 women cancer-

free at baseline
 En...
Results
 17.4 year follow up on average 4.81% developed

invasive breast cancer
 Of these cases:
 62.4% ER+/PR+
 20.2%...
Results
Results
 Highest Calcium Intake


34% less likely to develop ER-/PR- breast cancer

 Overall Calcium Intake



Decrea...
Discussion
Strengths

Weakness

 Prospective and

 Dietary intake was self-

population based
design
 Large sample size...
Conclusion
 Nutrient Mechanisms:




Calcium absorption is positively correlated with vitamin D
intake
Vitamin D works ...
Cohort: designed to show incidence; best for predicting risk
factors in research, based on exposure or no exposure

Pros

...
Questions
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Breast Cancer

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  • Is there something else that needs to be added here? I’m afraid the intro is too short.
  • Influence calcium absorption
  • ** Do we need this??
  • Might be better to start study 2 here
  • ** Those with higher intake were more likely to have higher education, lower alcohol intake, and lower dietary fiber intake.
  • Breast Cancer

    1. 1. Breast Cancer SEAN DAVENPORT BRIANNA CANTRELL ASHLEY CLARK DANA OMARI EMILY SMITH OLIVIA WOOLIVER
    2. 2. Breast Cancer  Breast cancer refers to a malignant tumor that has developed from cells in the breast  Cells of the lobules  Milk producing glands  Ducts  Passages that drain milk from the lobules to the nipple  Less commonly:  Stromal tissues, which include the fatty and fibrous connective tissues of the breast.
    3. 3. What are the symptoms?  Swelling of all or part of the breast  Skin irritation or dimpling  Breast pain  Nipple pain or the nipple turning inward  Redness, scaliness, or thickening of the nipple or breast skin  Nipple discharge other than breast milk  Lump in the underarm area
    4. 4. Overview of Vitamin D  Role in serum calcium homeostasis – acts to increase or decrease serum calcium levels  Also aids in calcium homeostasis in other areas such as bone, kidney, intestine, etc.  Helps to maintain/control normal cell growth, differentiation, and proliferation
    5. 5. Overview of Calcium  Calcium plays a regulatory role in cell proliferation, differentiation, and apoptosis  Experimental studies show that Calcium intake is related to:    An inverse relationship with mammographic breast density Decreased fat-induced epithelial hyperproliferation of the mammary gland and chemically-induced mammary carcinogenesis in rodents Reduced amount of breast cancer precursors in epidemiologic studies
    6. 6. Study 1: Intakes of Calcium and Vitamin D and Breast Cancer Risk in Women  Background  Increasing Calcium and Vitamin D intake in female mice led to regression in mammary tumors.  Evaluation of Calcium and Vitamin D intake  Subjects were divided into groups  10,578 Premenopausal women  20,909 Post menopausal women 45 years or older
    7. 7. Dietary Assessment  Food frequency questionnaire  Average use of food and beverages past 12 months  Calcium and Vitamin D intakes included sources from both Diets and Supplements
    8. 8. Ascertainment of Breast Cancer Cases  Follow up questionnaires on whether breast cancer was diagnosed  Every 6 months for first year  Annually after first year  Medical records attained to confirm diagnosis/death  Average 10 year follow-up of incident invasive breast cancer  276 premenopausal women diagnosed  743 post menopausal women diagnosed
    9. 9. Influences  Examination of dietary factors  Vitamin D  Phosphorus  Fat  Lactose
    10. 10. Results  Relation to function:  Premenopausal women Higher intakes of total Calcium & Vitamin D were associated with lower risk of breast cancer  Postmenopausal women No association between calcium/Vitamin D levels and risk of breast cancer  Possible explanation: relationship between Calcium, Vitamin D, and IGFs
    11. 11. Discussion  Calcium, Vitamin D, and IGFs:  Suggestion that Calcium & Vitamin D have anti-cancer effects on breast cancer cells expressing high levels of IGF-1 & IGF binding protein 3  Promote growth inhibition  IGF levels decline with age
    12. 12. Discussion Strengths Weaknesses  Large sample size  Possible confound  Prospective design  Nutrient intake only  Long duration assessed once  Vitamin D intake from sunlight exposure  High follow-up rates
    13. 13. Study 2: Long-term dietary calcium intake and breast cancer risk in a prospective cohort of women  To examine the potential association between Calcium intake and breast cancer risk and whether this association varies by ER/PR status of the breast tumor
    14. 14. Subjects and Methods  Swedish Mammography Cohort  Population-based cohort of 61,433 women cancer- free at baseline  Enrollment: 1987-1990  Two questionnaires:   Baseline 1997  Case ascertainment for ER/PR status  Pathology labs, Clinical databases
    15. 15. Results  17.4 year follow up on average 4.81% developed invasive breast cancer  Of these cases:  62.4% ER+/PR+  20.2% ER+/PR 12.9% ER-/PR 4.5% ER-/PR+  Adjustments made for:  Dietary Vitamin D  Conjugated Linoleic Acid intake
    16. 16. Results
    17. 17. Results  Highest Calcium Intake  34% less likely to develop ER-/PR- breast cancer  Overall Calcium Intake   Decreased receptor-negative species of breast cancer However, association was not statistically significant
    18. 18. Discussion Strengths Weakness  Prospective and  Dietary intake was self- population based design  Large sample size  Detailed info on diet  Info on hormone receptor status administered FFQ  Confounding variables
    19. 19. Conclusion  Nutrient Mechanisms:   Calcium absorption is positively correlated with vitamin D intake Vitamin D works inversely with estrogen receptors (ERs) and progesterone receptors (PRs), and actually has its own receptors (VDRs) in mammary glands/tissue  Apart from its role in aiding calcium absorption, the receptors for vitamin D found here could indicate a bigger part in preventing cancer  This facet needs further research for conclusive evidence
    20. 20. Cohort: designed to show incidence; best for predicting risk factors in research, based on exposure or no exposure Pros Cons  Easier to administer  Hard to identify  Cheaper than controls  Blinding is difficult  Recall &/or volunteer bias conducting a Randomized Control Study (RCT)
    21. 21. Questions

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